Postural orthostatic tachycardia syndrome (POTS) is a somewhat mysterious condition that we have just begun to understand better in recent decades. In people with POTS, the nerve system sends faulty signals to the blood vessels, resulting in blood being sent to the wrong places at the wrong times. The most easily identifiable symptom is a significant increase in heart rate when standing, often resulting in lightheadedness or dizziness.

POTS most often affects those between adolescence and age 35, and is more common in women than men. The condition can make everyday chores feel exhausting, and the frequent dizziness can make regular driving dangerous or impossible.

But because the symptoms affect so many different systems of the body, including breathing, heart rate and digestion, it’s often difficult for these patients—and their doctors—to figure out what’s wrong. One survey of more than 3,000 patients with POTS noted that, on average, these patients visited seven care providers and went four years before receiving a diagnosis.

Doctors also are uncertain what causes POTS. There seem to be some genetic and hormonal tendencies, and possibly autoimmune components, but nothing clear. For many patients, it seems, a significant injury or illness such as a concussion or mononucleosis—or even pregnancy—triggers the onset of POTS.

In the end, diagnosis often is made using a tilt table test, in which the heart rate and blood pressure are measured as the patient moves from a lying down position to an upright position.

While there is currently no known cure for POTS, the condition can be managed to allow patients to maintain a good quality of life. Recommendations differ, but the most important things are to drink plenty of fluids and add salt to your diet. This helps increase blood volume and pressure. Some medications also can help, as can physical activity, if the patient is able to be active.

Andrew Brenyo, MD, FHRS is a board-certified electrophysiologist and the medical director of electrophysiology laboratories at Greenville Health System. He earned his medical degree at the University of Buffalo in 2006, completed his medical residency at Duke University in 2009 and completed his fellowship in advanced cardiovascular electrophysiology from the University of Rochester in 2013. He is a specialist in the treatment of complex ventricular and atrial arrhythmias.